Healthcare Provider Details
I. General information
NPI: 1801578471
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 CLINT MOORE RD STE 182
BOCA RATON FL
33487-5713
US
IV. Provider business mailing address
4971 LE CHALET BLVD STE 100
BOYNTON BEACH FL
33436-1418
US
V. Phone/Fax
- Phone: 561-570-2627
- Fax: 561-570-2627
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JORGE
GARCIA
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 561-537-4526